• Restorative Dentistry and Endodontics
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• v.27 no.6
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• pp.577-586
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• 2002

The purpose of this in vitro study was to compare the effects of root canal cleanness following two Ni-Ti rotary instruments with different rake angle. Thirty-six sound, extracted human premolars with single root were randomly divided into three groups. The used rotary instruments were HEROShaper (Group 1, Micro-Mega, Besancon, France, n=12) and ProFile (Group 2, Maillefer, Ballaigues, Switzerland, n=12). Control group (n=12) was only extirpated with barbed broach (Mani, Matsutani Seisakusho Co., Japan) Group 1 & 2 teeth were prepared to a #40/.04 taper at the apex followed by 1 mm using crown-down technique. After canal preparation and frequent irrigation with 5.25% sodium hypochlorite, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. All root specimens were processed for SEM investigation and photographed. Separate evaluations by one endodontist were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. The penetration depth of smear layer into dentinal tubules was also estimated in the other halves. Following results were obtained: 1. Smear layer was observed on all the prepared walls with two experimental groups except control group. 2. Smear layer characteristics in two experimental groups; 1) HEROShaper group showed snowy, dusty appearance and were shown open dentinal tubuli on the prepared walls of almost specimens, and the thickness of smear layer covering onto dentinal surfaces was within 1-2 ${\mu}m$ in a few specimens. 2) ProFile group showed shiny, burnished appearance and complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli in all specimens. The penetration of smear layer into dentinal tubules was found in all specimens and the thickness was at 2-4 ${\mu}m$ in all specimens. These results demonstrated that a completely clean root canal could not be achieved regardless of positive or negative rake angle, which is in accordance with the majority of previous studies on root canal cleanliness In conclusion, through irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal wall in spite of Ni-Ti instrumentation.

• Restorative Dentistry and Endodontics
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• v.33 no.1
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• pp.20-27
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• 2008

The purpose of this study was to evaluate the consistency of two electronic apex locators in vitro model. Materials consisted of fifty two extracted premolars and two electronic apex locators; Root ZX (J. Morita, Osaka, Japan) and E-Magic Finder Deluxe (S-Denti. Cheonan, Korea). After access preparation, the teeth were embedded in a saline-mixed alginate model. Canal lengths of each tooth were measured at "0.5" and "Apex" mark of the apex locators, respectively so that each tooth had two measurements from 0.5 and Apex points. The file was fixed at final measurement using a glass ionomer cement. The apical 4 mm from the apex was exposed to measure the distance from the file tip to the major apical foramen of each tooth. Average distances and standard deviations were used to evaluate the consistency. Results showed that all measurements of both Root ZX and E-Magic Finder located the major foramen the range of ${\pm}0.5\;mm$ level. Both apex locators showed better consistency at Apex mark than at 0.5 mark. The average distance of file tip-major foramen was - 0.18 mm at 0.5 mark and - 0.07 mm at Apex mark in Root ZX, - 0.25 mm at 0.5 mark and - 0.02 mm at Apex mark in E-Magic Finder. Standard deviation was 0.21 at 0.5 mark and 0.12 at Apex mark in Root ZX, 0.12 at 0.5 mark and 0.09 at Apex mark in E-Magic Finder.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.1-14
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• 1999

Ursodeoxycholic acid(UDCA) is a hydrophilic gall bladder acid and has been used as a effective drug for liver disease related to in1munity. This drug inhibits secretions of IL-2, IL-4, and $IFN-{\gamma}$ from T-cells and production of immunoglobulin from B-cells. Also it has been reported that UDCA inhibits production of IL-1 related to the progression of periodontal disease and activation of collagenases. The purpose of the present study was to elucidate the effects of UDCA on inhibition of periodontal disease progression using clinical, microbiological and histometrical parameters. Twelve pure bred, 16 month-old-beagle dogs were used in the study. After ligature-induced periodontal diseases were formed, experimental drugs were applied twice a day and then the results of clinical, microbiological, and histometrical parameters were measured at baselie(initiation of experiment) , 4weeks and 8weeks. The gel with UDCA(concentration 0.5%, 5% 3 dogs in each) was applied to experimental group, chlorhexidine to positive control group(3dogs) and the gel without UDCA(base) to negative control group. After induction of general anesthesia, the maxillary 2nd, 3rd premolars and 1st molar and the mandibular 2nd, 3rd, 4th premolars and 1st molar were ligated in one side selected randomly and were not ligated in the opposite side. The plaque index(PI), gingival index(GI), pocket depth(PD) and gingival crevicular fluid(GCF) volum were measured clinically. The PI and GI were measured at 3 buccal points of all experimental teeth and the GCF was measured only at the 3rd premolar in the maxilla and the 4th premolar in the mandible. In the microbiological study, the samples extracted from the 3rd premolar of the maxilla and the 4th premolar of the mandible at the center of buccal surface were analyzed aerobics, anaerobics and Streptococcus colony forming units, After clinical and microbiological examination at 8weeks, the dogs were sacrificed by carotid artery perfusion. The samples were fixed and sectioned including interproximal area, and the distance from cementoenamel junction(CEJ) to alveolar crest was measured. The results were that PI, GI and PD increased until 4 weeks and decreased at 8 weeks in three groups but the differences between all the groups were not significant. The 0.5% UDCA in non-ligated group showed remarkable decrease of GCF. The experimental group applied 5% UDCA decreased the number of aerobics and anaerobics. The distance from CEJ to alveolar crest was greater in the negative control group on both ligated and non-ligated sides, but the differences were not significant stastically.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.561-578
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• 1999

The goal of periodontal therapy is the periodontal regeneration by the removal of microorganisms and their toxic products from the periodontally diseased root surface. To achieve periodontal regeneration, root conditioning as an adjunct to root planing has been done. There are low pH etchants such as citric acid, tetracycline-HCl, and EDTA solution which is a neutral chelating agent. The purpose of present study was to examine the effect of root conditioning by citric acid, tetracycline HCl, and EDTA. Total 35 root specimens(6${\times}$3${\times}$2mm) were prepared from the periodontally diseased teeth, scaled and root planed. The specimens were treated with normal saline for 1 minute, saturated citric acid(pH 1) for 3 minutes, 50mg/ml tetracycline-HCl(pH 2) for 5 minutes, 15% EDTA(pH 7) for 5 minutes using rubbing technique. The specimens were examined under scanning electron microscopy at 1000, and 3000 magnification. On the microphotographs taken at 1000 magnification, the numbers of opened and patent dentinal tubules per unit area(10,640${\mu}m^2$) were counted. And the diameters of opened dentinal tubules per unit are (10,640${\mu}m^2$) were measured. The differences of number and diameter among all groups were statistically analyzed by Kruskal Wallis Test. The results were as follows; 1. In the specimens applied with normal saline(control group), the root surface was finely cracked, and was covered by irregular smear layer. Neither exposed dentinal tubules nor any patent dentinal tubules could be seen. 2. In the specimens applied with saturated citric acid(experimental 1 group), the globular collagen fibers were exposed around the peritubular space, and many dentinal tubules were revealed. 3. In the specimens applied with tetracycline-HCl(experimental 2 group), the process-like collagen fibers were exposed around the peritubular space, and some dentinal tubules were revealed. 4. In the specimens applied with 15% EDTA(experimental 3 group), the root surface was covered by the collagenous fibrillar network, and many dentinal tubules were revealed. 5. The numbers of opened and patent dentinal tubules were significantly more in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the number of opened and patent dentinal tubules could not be counted because any dentinal tubules couldn't be seen. 6 . The diameter of opened dentinal tubules was significantly smaller in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the diameter of opened dentinal tubules could not be measured because any dentinal tubules couldn't be seen. The results demonstrate that root conditioning with citric acid, tetracycline- HCl, and EDTA is more effective in periodontal healing than only root planing, and 15% EDTA solution can replace low pH etching agents such as citric acid, tetracycline-HCl for root conditioning.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.457-464
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• 2005

The purpose of our study was to investigate whether the intrapulpal temperature during cavity preparation of enamel or dentin with Er:YAG laser still remained in range of safety for dental pulp protection when combined with appropriate water flow rate. The effect of different pulse repetition rates at the same pulse energy during ablation was evaluated as well. Caries-free, restoration-free extracted human molar teeth were prepared for the specimen and divided two experimental groups of enamel and dentin. Each group comprised 5 specimens and each of tooth specimens were embedded into a resin block each and measuring probe was placed on the irradiated pulpal walls. For experiments of dentin ablation, enamel layers were prepared to produce dentin specimen with a same dentin thickness of 2 mm. A pulse energy of Er:YAG laser was set to 300 mJ and three different pulse repetition rates of 20 Hz, 15 Hz and 10 Hz were employed. Laser beam was delivered with 3 seconds and less per application over enamel and dentin surfaces constant sized by $3\;mm{\times}2\;mm$ and water spray added during irradiation was a rate of 1.6 ml/min. Temperature change induced by Er:YAG laser irradiation was monitored and recorded While enamel was ablated, there was no significant difference of temperature related to pulse repetition rates(p=0.358) and temperature change at any pulse repetition rate was negligible. Significant statistical difference in temperature changes during cavity preparation in dentin existed among three different pulse groups(p=0.001). While temperature rise was noticeable when the dentinal wall was perforated, actual change of temperature due to Er:YAG laser irradiation was not enough to compromise safety of dental pulp when irradiation was conjugated with appropriate water spray. Conclusively, it can be said that cavity preparation on enamel or dentin with an Er:YAG laser is performed safely without pulp damage if appropriate volume of water is sprayed properly over the irradiated site.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.379-388
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• 2002

For the success of dental implant, accurate radiographic evaluation is prerequisite for planning the location of the osseointegrated implants and avoiding injury to vital structures. CT/MPR(computed tomography/multiplanar reformation) shows improved visualization of inferior alveolar canal. In order to obtain cross-sectional images parallel to the teeth, the occlusal plane is used to orientate for the axial plane. If the direction of axial plane is not parallel to the occlusal plane, the reformatted cross-sectional scans will be oblique to the planned fixture direction and will not show the actual dimension of the planned fixture's location. If the available bone height which measured in the cross-sectional view is much greater than the actual available bone height, penetration of canal may occur. The aim of this study is to assess the effect of the axial plane to measurement of available bone height for dental implant in computed tomography of the mandible. 40 patients who had made radiographic stents and had taken CT were selected. The sites that were included in the study were 45 molar regions. In the central panoramic scan, the length from alveolar crest to superior border of inferior alveolar canal(available bone height, ABH) was measured in direction of reformatted cross-sectional plane(uncorrected ABH). Then, length from alveolar crest to superior border of canal was measured in direction of stent(corrected ABH). The angle between uncorrected ABH and corrected ABH was measured. From each ABH, available fixture length was decided by $Br{{\aa}}nemark$ system. The results were following ; the difference between two ABHs was statistically significant in both first and second molar(p< 0.01). The percentage of difference more than 1 mm was 8.7% in first molar and 15.5% in second molar. The percentage of difference more than 2 mm was 2.0% in first molar and 6.6% in second molar. The maximum value of difference was 2.5 mm in first molar and 2.2 mm in second molar. The correlations between difference of 2 ABHs and angle was positive correlations in both first and second molar. The correlation coefficient was 0.534 in first molar and 0.728 in second molar. The second molar has a stronger positive correlation. The percentage of disagreement between 2 fixture lengths from two ABHs was 24.4% in first molar and 28.9% in second molar.

• Journal of Periodontal and Implant Science
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• v.23 no.1
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• pp.77-96
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• 1993

This in vitro study was undertaken to observe whether citric acid application aids the attachment and proliferation of human periodontal ligament cells to the root surfaces of periodontally diseased teeth. The roots were prepared so that the comparison could be made among the control healthy root surface, citric acid demineralized and non-demineralized root planted surfaces. Prior to the cell attachment experiment, each groups were prepared for scanning electron microscopic (SEM) examinations of root surface morphology, All specimens were fixed with phosphate buffered glutaraldehydes, postfixed with phosphate buffered osmium tetraoxide and stained with phosphate buffered tannic acid. dehydrated in ethanol, critical point dried, sputter coated with gold and examined under the SEM. In the cell attachement experiment, human cultured periodontal ligament cells at concentration to $4.5{\times}\;10^4\;cells/ml$ were seeded in each culture well which contained prepared roots and incubated for 30min 1, 2, 6, 12 and 24 hours at 37, 5% $CO_2$air incubator. Than the specimens were prepared for SEM examination using, the same methods as described above. In the cell proliferation experiment, $5{\times}\;10^4\;cells/ml$ cells were seeded incubated with the specimens for 6 hours. Then, all of the specimens were moved into fresh culture well and incubated for 24, 48, and 72 hours. The cell counting was done after trypsinization, under light microscope. The results were as follows. When viewed the surface morphology prior to the cell attachment, the non acid treated root planed surface displayed scaling striation and occasional bacteria and calculus. The citric acid treated specimens displayed little debris on the surface and funnel shaped orifices of dentinal tubules. There were no apparent differences in the morphology of cells attached to the control and experiment groups. However, in initial attachement, there was a slight more enhanced appearance in attachment in citric acid treated groups than other root surfaces. After 6 hours of incubation, most of the cells initiated the alteration of cell morphology from ovoid to spindle shapes. After 24 hours of incubation, most of the cells displayed proliferated appearance and connected with each other via numerous processes. In the cell proliferation experiments, there were statistically significant increased number of cells in citic acid treated groups than other groups.

• Journal of Periodontal and Implant Science
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• v.23 no.1
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• pp.97-108
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• 1993

One of the important initial events required for periodontal regeneration is the attachment and subsequent spreading of periodontal ligament cells on the root surface. The purposes of this study is to investigate the attachment and spreading pattern of human periodontal ligament cell on the surface of glass slides. After establishment of a cell line of the primary cell culture from the periodontal ligament of 1st premolar teeth which were extracted for the purpose of orthodontic treatment, author dispersed the cells at $5{\times}10^3\;cells/ml$ into the each 35mm culture petri-dish containing 2 glass slides. To observe the morphological changes of the cells which attached to the surfaces of glasses at every designed time schedule, author used the inverted phase contrast microscope and scanning electron microscope. During the whole experiment culture condition was at $37^{\circ}C$, 100% Humidity, 5% $CO_2$ gas incubator. The following results were obtained. Periodontal ligament cells showed spherical outline and started to attach to glass surface by basal sytoplasmic extension after 10min in culture. After 30min in culture, periodontal ligament cells were attached to glass surface by well - developed filopodia which protruded from the lamellipodia. The cell surface is covered with bubble-like structures and occasional microvillus can be seen with diffculty among these structures. After 1.5hr in culture, peridontal ligament cells shhowed radially well-spread cytoplasm and the nucleus was centered on its cytoplasm. Unspread central region of the cell was covered with numerous microvilli. The change of cell attachment and spreading pattern was manifest at 6hr in culture. At this time, periodontal ligament cell showed elongated outline and an oval-shaped nucleus. After 12hr in culture, periodontal ligament cells showed more stretched fibroblast-like appearance with polarity. Two long lamellipodia can be seen around the both terminal ends of cells. After 24hr in culture, periodontal ligament cells showed spindle shapes and an oval-shaped nucleus was slanted toward one side of the cell.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.3
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• pp.145-155
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• 2002

The results of the present feasibility study are summarized as follows, 1. The three unit bridge of knitted material and UD fibre reinforcement has both the rigidity and the strength against a vertical occlusal load of 75N. 2. Stress concentration at the junctional area between the bridge and the abutments, i.e. between the pontic and the knitted caps was observed. In the case of the bridge with reinforcement straps, it was partly shown that the concentration problem could be improved by simply increasing the fillet size at the area. Further refining in the surface of the junctional area will be needed to ensure a further improvement in the stress distribution. This will require some trade off in the level of the stress and the available space. A parametric study will help to decide the appropriate size of the fillet. 3. Design refinement is a must to improve the stress distribution and realize the most favourable shape in terms of fabrication. The current straight bar with a constant cross section area can be redesigned to a tapered shape. The curve from the dental arch should also be placed on the pontic design. In accordance with design refinement, the resistance of the bridge frame to other load cases should be evaluated. 4. Although not included in the present feasibility study, it is estimated that bridges of the anterior teeth can be made strong enough with the knitted material without further reinforcement using unidirectional materials. In this regard, a feasibility study on design concepts and stress analysis for 3, 4, 5 unit bridge is suggested. 5. Two types of bridge were analysed in terms of fatigue. The safe life design concept, i.e. fatigue design concept, looks reasonable for the bridge where if cracks should form and propagate there is virtually nothing a dentist to do. The bridge must be designed so that no crack will be initiated during the life span. In the case of crowns, however, if constructed with composite resin with knitted materials, it might be possible to repair them, which in general is impossible for crowns of PFM or of metal. Therefore for composite resin crowns, a damage tolerance design concept can be applied and reasonably higher operational stresses can be allowed. In this case, of course, a periodic inspection program should be established in parallel. 6. Parts of future works in terms of structural viewpoint which need to be addressed are summarized as the following: 1) To develop processing technology to accommodate design concepts; 2) More realistic modelling of the bridge and analysis-geometry and loading condition. Thickness variation in the knitted material, taper in the pontic, design for anterior tooth bridge, the effect of combined loads, etc, will need to be included; 3) To develop appropriate design concepts and design goals for the fibre composite FPD aiming at taking the best advantage of knitted materials, including the damage tolerance design concept; 4) To develop testing method and perform test such as static ultimate load test, fatigue test, repair test, etc, as necessary.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.252-259
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• 2017

Purpose: The purpose of this study was to compare and analyze the wear of a prosthesis for 6 months after restoration with implant-supported fixed dental prosthesis made of either zirconia or gold. Materials and Methods: This study was conducted on patients requiring implant-supported fixed dental prostheses on first or second molar from January, 2015 to January, 2016. A total of 47 prostheses and antagonists were examined. Occlusal surface was recorded by impression of each prosthesis and antagonist 1 week and 6 months after prosthesis delivery. The digital files were created by impression scan. Occlusal shapes of 1 week and 6 months were compared and wear of prostheses and antagonists was analyzed. The Mann-Whitney test was used to analyzed the result data underwent normality test using SPSS (Version 23.0, IBM Corporation) Results: Mann-Whitney test revealed that there was no statistically significant difference in the median amount of mean vertical wear for 6 months in zirconia ($50.84{\mu}m$) and gold ($42.84{\mu}m$) prostheses (P > 0.05). When the opposing teeth were natural, the median amount of mean vertical wear of zirconia and gold prostheses was $47.72{\mu}m$ and $41.97{\mu}m$, respectively, and the median amount of mean vertical wear of enamel was $47.26{\mu}m$ and $44.59{\mu}m$, respectively. Statistical analysis showed no significant difference (P > 0.05). Conclusion: Despite the short study period and the small number of experimental groups, zirconia and gold showed no significant difference in wear during the first 6 months. Opposing natural enamel also showed no significant difference in the wear.